Paul Grundy, M.D., M.P.H.
Guest Post: Let’s Not Accept Fragmented Medication Data as a Normal State of Affairs
When physicians get together, we swap stories like athletes recounting the thrill of victory and the agony of defeat. It’s a way to share patient success stories and help each other cope with the frustrations of less-than-ideal outcomes.
Recently, a physician friend told me about a patient who was taking fluoxetine to help manage depression. The patient developed a sinus infection on a Friday evening, and over the weekend went to an urgent care center for treatment. Unfortunately, when asked about his medication history, the patient forgot to mention the fluoxetine. The provider prescribed azithromycin, which has a known risk of causing QT prolongation (a condition that can lead to ventricular arrhythmia) when taken with fluoxetine.
Unfortunately, that’s exactly what happened. The patient suffered from a ventricular tachycardia triggered by a QT prolongation and collapsed in a busy shopping mall. Thankfully, a bystander grabbed an automated external defibrillator (AED) in time to save his life.
Why didn’t that provider know the prescription she wrote was putting the patient’s life in danger? It’s simple: She had no record of his medication history and the patient forgot to share this vital information. It doesn’t have to be that way.
Missing or Incomplete Medication Data Impacts Patient Safety
Because knowing what medications a patient is taking can make the difference between life or death, it’s frustrating that the healthcare industry seems to accept fragmented medication data as a normal state of affairs.
Medication therapy is central to modern medical treatment. For example:
- Antibiotics support a safe recovery from surgical procedures.
- Vaccines limit the effects of communicable diseases.
- Drugs transform critical illnesses into manageable chronic conditions.
- Drugs manage, mitigate, or ameliorate behavioral health issues.
So, shouldn’t we be concerned when a patient’s medication data isn’t conveyed from a primary care practice to the urgent care center down the road? Shouldn’t red flags appear at the pharmacy filling a new prescription when the patient is taking a drug with a known interaction risk? Sadly, that doesn’t always happen if patients pay cash, use a cash discount card or pharmacy savings plan, or take advantage of free medication programs from the pharmaceutical company.
From the patient story above, it’s easy to see that if medication data were able to flow seamlessly between care settings, pharmacies, and patient records, the life-threatening adverse drug event could have been prevented.
Medication Non-Adherence Leads to Poor Outcomes
Another way medication data can help improve outcomes is by supporting medication adherence. If patients take the right medication, at the right time, in the right way, they can transform the quality of their lives. Unfortunately, cost, concerns about side effects, lack of transportation, and other factors can prevent patients from taking their medications as prescribed.
Medication non-adherence accounts for up to 50% of treatment failures in the United States, resulting in approximately 125,000 deaths each year.1 To promote behavior that improves outcomes, providers need to know whether patients filled their prescriptions and are taking them as instructed. No provider—regardless of how compassionate, perceptive, or insightful he or she may be—can shift patient behaviors that they don’t know about. Making prescription fill information available in the EHR makes it possible for a member of the care team to have a conversation with the patient to learn what obstacles are getting in the way.
Managing Medication Data to Better Manage Care
So what can we, as an industry, do? Fortunately, new technologies are improving the transfer of data and making it easier for providers to identify potential problems before they lead to a health crisis.
DrFirst’s data migration solutions are leveraging AI and machine learning to break down data silos, extract appropriate information, and effectively prepopulate the patient’s medical record with medication history data and insights to medication adherence at the point of care. For EHR vendors, this is essential for migrating data efficiently among multiple platforms and simplifying the process of onboarding clients. For your customers, it’s vital to solving data fidelity issues between disparate systems and formats so providers receive complete, clean, and consumable clinical data.
And that might just be the ultimate power of data: Giving providers the insight they need to make better, more informed care decisions that can prevent situations like the one that nearly took the life of my friend’s patient.
Source:
1. Kim, J., et al, “Medication Adherence: The Elephant in the Room,” U.S. Pharmacist, January 2018. https://www.uspharmacist.com/article/medication-adherence-the-elephant-in-the-room
About Paul Grundy, M.D., M.P.H.
Dr. Grundy is known as the Godfather of Patient-Centered Medical Homes (PCMH), a model that puts patients at the forefront of care. He has spent four decades focused on population health built on healing a relationship of trust in primary care. Dr. Grundy is founding President of the Primary Care Collaborative. He is also a Healthcare Ambassador for the nation of Denmark, one of seven Honorary Life Members of the American Academy of Family Physicians, and the only American awarded an Honorary Lifetime Membership in the Irish National Association of General Practice and the National Association of Primary Care in the United Kingdom.